title: Episode of coexisting infections with multiple dengue virus serotypes in central Karnataka, India.
abstract: BACKGROUND
  The co-circulation of multiple dengue virus serotypes has been reported in many parts of the world, including India; however, concurrent infection with more than one serotype of dengue virus in the same individual is rarely documented.
  
  
  METHODS
  An outbreak of dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS) occurred in and around Davangere, Karnataka, from June 2011-March 2012. This is the first report from India with a high percentage of concurrent infections with different dengue virus serotypes circulating during one outbreak. Acute phase sera from patients were tested for the presence of dengue virus RNA by RT-PCR.
  
  
  RESULTS
  Of the 72 samples tested for dengue virus RNA, 42 (58.3%) were positive. All four dengue virus serotypes were found to be co-circulating in this outbreak, and DENV-2 was the predominant serotype. In addition, concurrent infection with more than one dengue virus serotype was identified in 18 (42.9%) dengue virus-positive samples.
  
  
  CONCLUSIONS
  Our study showed that serotype DEN-2 was dominant in the positive dengue virus-infected samples; the other serotype present was DEN-3. This is the first report of concurrent infections with different dengue virus serotypes in this part of the world.
authors.affiliation: Department of Microbiology, S. S. Institute Medical Sciences & Research Centre, NH-4, Bypass Rd, Davangere 577005, Karnataka, India. vinodmicro@yahoo.com
authors.forename: C S
authors.initials: CS
authors.lastname: Vinodkumar
authors.forename: N K
authors.initials: NK
authors.lastname: Kalapannavar
authors.forename: K G
authors.initials: KG
authors.lastname: Basavarajappa
authors.forename: D
authors.initials: D
authors.lastname: Sanjay
authors.forename: Chandrasekar
authors.initials: C
authors.lastname: Gowli
authors.forename: Naveen G
authors.initials: NG
authors.lastname: Nadig
authors.forename: B S
authors.initials: BS
authors.lastname: Prasad
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D060085:Coinfection / Q000453:epidemiology* / Q000821:virology*; D003716:Dengue Virus / Q000145:classification / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D012367:RNA, Viral / Q000097:blood / Q000235:genetics; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012703:Serotyping; D019595:Severe Dengue / Q000453:epidemiology* / Q000821:virology*
chemical_list: D012367:RNA, Viral